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RFK Jr. turns MAHA-light

April 23, 2026
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Washington Correspondent, D.C. Diagnosis Writer

Sarah Todd’s MAHA snackdown article includes such merchandising gems as “fibermaxxing” chips, “protein-powered” yogurt, and “longevity” beverages. My generation’s biggest contribution to food marketing was light beer. Send news tips and brand management schemes to John.Wilkerson@statnews.com or John_Wilkerson.07 on Signal.

obesity drugs

Losing BALANCE

The Trump administration couldn’t get insurers to provide cheap obesity drugs to seniors through the Medicare pilot BALANCE. So Medicare will now make the drugs available to seniors outside of the Part D drug benefit in another pilot, called Bridge.

That means the $50 copay seniors spend each month for GLP-1’s won’t count toward deductibles and annual spending caps, according to Juliette Cubanski, deputy director of the Program on Medicare Policy at KFF. Under BALANCE, the copays would have counted.

Another difference for seniors: In the Bridge pilot, all beneficiaries will pay $50 monthly. With BALANCE, people enrolled in enhanced Medicare plans would’ve paid a $50 monthly copay and people in basic plans would’ve paid $125 each month, though most seniors are enrolled in enhanced plans.

Eli Lilly and Novo Nordisk are winners because they still get to sell weight loss drugs through Medicare, which is otherwise prohibited from covering obesity medications. They also don’t have to sell their GLP-1's for $245 for uses other than treating obesity. Had BALANCE gone forward, they would’ve had to charge $245 for all indications, a lower price than insurers currently pay.

The insurers win because they don’t have to cover obesity drugs at a loss.

The consensus among policymakers is that taxpayers lose because they’ll have to pay the entire cost of providing obesity drugs to seniors, instead of making insurers – and seniors, by way of higher premiums – foot some of that bill. The government hasn’t said what Bridge is expected to cost the government compared to BALANCE.



politics

A change of tune

From vaccines to herbicides and transparency, health secretary Robert F. Kennedy Jr. is singing a different tune these days, Daniel Payne and Chelsea Cirruzzo report.

The same guy who once said no vaccine is safe was on Capitol Hill this week touting what he’s done to encourage vaccination, including funding the development of new vaccines, approving new shots for patients, and urging parents to get their kids inoculated against measles, mumps, and rubella. He didn’t mention the health department’s decision to scrap the childhood vaccine schedule and dismantle ACIP.

He also portrayed the administration’s secret deals with drugmakers as standard practice and defended the administration’s plans to boost production of an herbicide that MAHA followers hate.

But Kennedy was still at times up to his old moves on vaccines. Read more about that.


budget

RFK Jr. hits resistance to budget cuts

Congress ignored most of the president’s proposals to cut funding for health research and public health in his first budget proposal, and senators seem likely to do so again this year, Chelsea reports.

Like last year, the White House again proposed deep cuts to the National Institutes of Health, the elimination of a health research agency, and the creation of a new agency devoted to chronic diseases called the Administration for a Healthy America.

And like last year, lawmakers at a Senate appropriations health subcommittee on Tuesday asked Kennedy how his department could tackle chronic disease, smoking cessation, and cancer research while cutting the HHS budget by 12%.

Read more for some spicy comments by appropriations Chair Susan Collins (R-Maine).


prior authorization

WiSER leads to longer waits

In Washington state, traditional Medicare beneficiaries are waiting two to four times longer for some hospital procedures now that they’re subject to prior authorization, Tara Bannow reports.

Private insurers are allowed to use prior authorization in Medicare Advantage. Traditional Medicare historically hasn’t incorporated the process, but the government is testing its use in a pilot program called WiSER.

That has several lawmakers worried. Sen. Maria Cantwell (D-Wash.) released the report on the impact of prior authorization and aired her concerns about WISeR to Kennedy at a Senate Committee on Finance hearing Wednesday. She said CMS is using AI as a “denial device” and that patients are waiting weeks to get approval for services that previously didn’t require it.

Read more.


cdc

‘A fox in the henhouse’

A former tobacco industry executive has been appointed to senior leadership at the Centers for Disease Control and Prevention, Sarah reports.

Stephen Sayle was named CDC’s deputy director for legislative affairs in March. He previously worked at Fontem Ventures, a subsidiary of the British multinational tobacco corporation Imperial Brands. Between 2017 and 2018, he was U.S. vice president of corporate affairs at Fontem, which is focused on non-combustible tobacco products like the e-cigarette brand blu and the oral nicotine pouch brand Zone.

A former head of the CDC’s Office of Smoking and Health called the appointment unprecedented. Read more.


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What we’re reading

  • At AACR, talk of Chinese biotech, oncology’s comms issue, and more, STAT
  • Flu vaccine no longer mandated for U.S. troops, defense secretary says, The Associated Press
  • CMS to ask every state for new audits of health care providers, STAT
  • The MAHA moms are falling in line, The Atlantic

Thanks for reading! More next time,


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